Organization
LESTER TENGSICO LLC
Active
Other names
Division Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LESTER TENGSICO (OWNER)
(503) 760-5151
Entity
Organization
Contact information
Practice address
10424 SE CHERRY BLOSSOM DR STE F, PORTLAND, OR 97216-2825
(503) 760-5151
(503) 760-5454
Mailing address
PO BOX 33912, PORTLAND, OR 97292-3912
(503) 760-5151
(503) 760-5454
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00263
OR
213ES0103X
Foot & Ankle Surgery Podiatrist
DP00263
OR
213ES0131X
Foot Surgery Podiatrist
DP00263
OR
Other
Enumeration date
01/12/2009
Last updated
01/12/2009
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